Child Eating Behavior Research Articles

Social networking sites: a new source of child feeding information for parents in Thailand.

Social networking sites (SNSs) provide opportunities for health and nutrition communication. Data are lacking on whether these SNSs influence Thai parent's food provisioning to young children. In the current study, we examined the prevalence and characteristics of Thai parents who reported participating in child food and nutrition-SNSs and investigated the association between participation in these sites and parents' perceptions and feeding practices. A sample of 379 Thai parents completed a survey about the use of child food and nutrition-SNSs, and feeding practices and child eating behavior. Around 70% of participants, especially female millennials with their first child, have participated in SNSs that provide information about children's diets. High engagement was more common among younger and less educated participants, as well as rural dwellers and those with abnormal body mass index. Among these SNSs' participants, those with higher engagement had higher levels of trust in the nutritional information shared on SNSs. Further analyses showed that parents who have joined these sites had positive associations with not only providing children with more fresh fruits and vegetable but also more processed meats. Further investigations are needed to explore the information these SNSs provided and what influences they have on parents' perceptions around feeding children.

Parent Education Class for Children With Feeding Difficulties

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to determine the feasibility and effectiveness of a multidisciplinary educational class for parents in improving child feeding behaviors and reducing caregiver distress associated with feeding difficulties. This class has proven to be effective in educating parents about the intricate and dynamic nature of feeding per positive responses on Behavioral Pediatrics Feeding Assessment Scale, Parent Mealtime Action Scale, and parent survey. Primary Author and Speaker: Adina P. Schwartz Additional Authors and Speakers: Judy Hopkins

An investigation of the relationship between the eating behaviours of children with typical development and autism spectrum disorders and parent attitudes during mealtime eating behaviours and parent attitudes during mealtime.

Nutrition has significant importance in the course of growth and development in early childhood. Selective and fussy eating is prevalent among children with autism spectrum disorder and can have a profound impact on parents' mealtime actions. The study aimed to investigate the relationship between parental mealtime actions and the eating behaviours of children aged 3-5 years with typical development (TD) and autism spectrum disorder (ASD). A total of 180 parents of children between 3 and 5 years in Ankara participated in the study; 90 were parents of children with TD, and 90 were parents of children with ASD. We measured the variables using the Brief Assessment of Mealtime Behaviour in Children (BAMBIC), Children's Eating Behaviour Questionnaire (CEBQ), and Parent Mealtime Action Scale (PMAS). The results revealed that food refusal, disruptive behaviours, and limited variety in TD children were related to parental actions, such as the use of rewards. We also found a negative correlation between enjoyment of food and the use of rewards. Children with ASD displayed differences concerning food refusal, and their parents were found to prepare more special meals for them compared with children with TD. Despite differences, the eating behaviours of children with TD and ASD show similarities in some cases. If a child has a low interest in eating, then their parents tend to be more insistent, use more rewards, and offer special meals. On the contrary, a child's high interest in eating harms such parental behaviours. Because an acknowledgement that a relationship exists between the eating behaviours of children and parental actions would make intervening to shape parental attitudes easier, it is recommended that future studies should be carried out to respond to the eating problems of children by working with parents.

Preliminary exploration of the use of the Children's Eating Behaviour Questionnaire (CEBQ) and Feeding Practices and Structure Questionnaire (FPSQ) in Vietnamese mothers.

This preliminary pilot study aims to explore the use of the Feeding Practices and Structure Questionnaire (FPSQ) and Children's Eating Behaviour Question (CEBQ) in a sample of Vietnamese mothers. Cross-sectional data from the FPSQ and CEBQ were collected from a convenience sample of mothers (n = 102) who attended the Ho Chi Minh City Nutrition Centre in Viet Nam. Mothers had at least one child aged 2-5 years. The reliability of the questionnaire subscales was tested using Cronbach's alpha coefficients. Face validity was assessed using dialogue from a translation-back-translation procedure undertaken by an expert committee, and cognitive interviews conducted in a subsample of mothers (n = 6). Based on these findings, exploratory factor analyses (EFAs) were performed to assess the underlying structures of both questionnaires in this sample. Cronbach's alpha coefficients for the original questionnaires ranged from 0.23 to 0.92. Limitations in translation and comprehension of items surfaced, warranting modifications of the questionnaires, which were subsequently examined using EFA. EFA of the FPSQ and CEBQ revealed a six-factor structure with 23 items, and a six-factor structure with 27 items, respectively, which were interpretable solutions for this sample. Cronbach's alpha coefficients were >0.70 for all subscales in the revised questionnaires. Modified versions of the FPSQ and CEBQ are proposed for use in Viet Nam. However, prior to their use, further reliability and validity testing must be undertaken in larger samples, including assessment of test-retest reliability and construct validity, as well as confirmatory factor analysis to verify the proposed factor structures.

Barriers to Accessing Healthy Food and Food Assistance During the COVID-19 Pandemic and Racial Justice Uprisings: A Mixed-Methods Investigation of Emerging Adults’ Experiences

BackgroundA steep rise in food insecurity is among the most pressing US public health problems that has resulted from the COVID-19 pandemic. ObjectiveThis study aimed to (1) describe how food-insecure emerging adults are adapting their eating and child-feeding behaviors during COVID-19 and (2) identify barriers and opportunities to improve local food access and access to food assistance. DesignThe COVID-19 Eating and Activity Over Time study collected survey data from emerging adults during April to October 2020 and completed interviews with a diverse subset of food-insecure respondents. Participants/settingA total of 720 emerging adults (mean age: 24.7 ± 2.0 years; 62% female; 90% living in Minnesota) completed an online survey, and a predominately female subsample (n = 33) completed an interview by telephone or videoconference. Main outcome measuresSurvey measures included the short-form of the US Household Food Security Survey Module and 2 items to assess food insufficiency. Interviews assessed eating and feeding behaviors along with barriers to healthy food access. Analyses performedDescriptive statistics and a hybrid deductive and inductive content analysis. ResultsNearly one-third of survey respondents had experienced food insecurity in the past year. Interviews with food-insecure participants identified 6 themes with regard to changes in eating and feeding behavior (eg, more processed food, sporadic eating), 5 themes regarding local food access barriers (eg, limited enforcement of COVID-19 safety practices, experiencing discrimination), and 4 themes regarding barriers to accessing food assistance (eg, lack of eligibility, difficulty in locating pantries). Identified recommendations include (1) expanding the distribution of information about food pantries and meal distribution sites, and (2) increasing fresh fruit and vegetable offerings at these sites. ConclusionsInterventions of specific relevance to COVID-19 (eg, stronger implementation of safety practices) and expanded food assistance services are needed to improve the accessibility of healthy food for emerging adults.

Associations between the infant and young child feeding index and nutritional status.

The infant and child feeding index (ICFI) is a single summary World Health Organization influenced index to assess feeding quality in infants and young children aged 6-36months. This study aimed to demonstrate any associations between ICFI and nutritional status in a single Thai center. The demographic data and feeding practices of healthy infants and children aged 6-36months were collected from questionnaires given to 304 parents/caregivers; anthropometric measurements were taken. Associations between ICFI and weight-for-age Z scores (WAZ), length/height for age Z scores (LAZ/HAZ), weight-for-length/height Z scores (WLZ/WHZ), and body mass index-for-age Z scores (BAZ) were examined. The mean ICFI was 6.14 ± 1.63 and was lowest in the 6-8months age group. Breastfed infants had significantly higher ICFI scores than those not breastfed. Factors influencing ICFI were infant age and milk volume intake. The ICFI was negatively associated with WAZ, WLZ/WHZ, and BAZ (β = -0.13, P = 0.037; β = -0.17, p=0.01; β = -0.15, P = 0.026, respectively). Breastfeeding was also negatively associated with WAZ, LAZ/HAZ, WLZ/WHZ, and BAZ. This study demonstrated a negative association between the ICFI and nutritional status. Breastfeeding may have obscured some positive effects from appropriate feeding practices, while dairy consumption may have hidden negative outcome from inappropriate ones. Despite the ICFI appearing to reflect infant and young child feeding behaviors, using the ICFI alone may not accurately reveal nutritional status.

P60 Parents Perceptions of Their Personal Eating Habits and Their Child's Eating Behaviors

<h3>Background</h3> Parent perception of their child's and their own eating habits may influence feeding and eating behaviors. <h3>Objective</h3> To evaluate associations between the parent's perceptions of their own eating habits and their perception of their child's eating habits. <h3>Study Design, Setting, Participants</h3> A cross-sectional online survey distributed via social media to parents/caregivers of children aged 3 to 8 years. The questionnaire included the ecSI 2.0, CEBQ and demographic items. Pearson's correlations were used to examine relationships between the ecSI 2.0TM and CEBQ subscale scores. <h3>Measurable Outcome/Analysis</h3> Ellyn Satter's 16-item Competence Inventory (ecSI 2.0TM), includes 4 subscales: eating attitudes, food acceptance skills, internal regulation skills and contextual skills of adults. The 35-item Child Eating Behavior Questionnaire (CEBQ) parent report measure assesses picky eating using 8 subscales; food responsiveness, emotional over-eating, enjoyment of food, desire to drink, satiety responsiveness, slowness in eating, emotional undereating and food fussiness. Chi-square, analysis of variance (ANOVA) and <i>t</i> tests were used to analyze ecSI 2.0TM and CEBQ subscale scores with demographics variables. <h3>Results</h3> The majority of respondents (n = 186) were female (93.5%), White (82.3%) and married (88.7%). Half (49.5%) were ≥36 years of age and most (75.8%) held college degrees. Half (53.2%) of the children were female, and child age was evenly distributed. The adults deemed eating competent differed by parent age and household income, χ²(5,186) = 12.57, <i>P</i> = 0.03 and χ²(1, 186) = 6.27, <i>P</i> = 0.01, respectively. There was a significant difference in child's enjoyment of food, t(184) = -2.30, <i>P</i> = 0.003, with higher scores found in eating competent parents. A significant difference in a child's desire to drink was found, t(184) = 2.59, <i>P</i> = 0.01, with lower scores among eating competent parents. <h3>Conclusion</h3> Findings suggest eating competence among parents may play a role in their child's eating behavior. Suggested relationships between parent eating competence and perceived child eating behavior warrant additional research and these can be used to provide insight on perceived child eating behavior studies.

Food parenting practices and eating behaviors in childhood: a cross-lagged approach within the Generation XXI cohort

Food parenting practices have been associated with children's eating behaviors, but analyses exploring the bidirectional effects are limited. We aimed to examine the bidirectional relations between food parenting practices and the eating behavior of children from 4 to 7 y old. Participants are from the Generation XXI birth cohort (Portugal) assessed at both 4 and 7 y of age (n=3698 singletons). A validated version of the Child Feeding Questionnaire and the overt/covert control scale were used. Three patterns of food parenting practices (Perceived Monitoring, Restriction, and Pressure to eat) were studied. Perception of children's eating behaviors (eating large amounts of food, eating very slowly, and food refusal) was reported by parents (measured using dichotomous questions). Cross-lagged analyses were performed to evaluate the direction of the associations (parenting practices at 4 y to behaviors at 7 y and the reverse). Eating large amounts of food was unidirectionally associated with higher Restriction 3 y later (βstandardized=0.047; 95% CI: 0.019, 0.075). Apart from Restriction, all associations had a bidirectional effect of similar magnitude. Eating large amounts of food and food refusal at age 4 influenced food parenting, such as Perceived Monitoring and Pressure to eat at age 7, but these practices were prospectively linked to these eating behaviors too (e.g., βstandardized=0.033; 95% CI: 0.022, 0.064 for food refusal at age 4 and Pressure to eat at age 7, and βstandardized=0.060; 95% CI: 0.034, 0.086, in the reverse direction). Parenting practices and children's eating behaviors showed significant moderate tracking (standardized path coefficients from 0.24 to 0.49). Eating large amounts of food, eating slowly, and food refusal can influence parents to adopt certain food parenting practices, but these practices also influence children's behaviors after a few years. This reciprocal relation should be considered in future research. Parents should be advised to use food parenting practices associated with healthier eating behaviors.

P113 Parental Correlates of Preschoolers’ Physical Activity

<h3>Background</h3> In combination with healthy eating, physical activity is an essential component of a healthy lifestyle that can help prevent a range of chronic diseases among children. As role models and gatekeepers, parents can influence children's eating and physical activity behaviors through healthy practices, helping and teaching children to make healthy choices for themselves that will last a lifetime. <h3>Objective</h3> To investigate the associations between demographic characteristics, parental feeding practices, and child physical activity in preschool-age children. <h3>Study Design, Setting, Participants</h3> Participants of this cross-sectional study included parents (n = 273) of preschool-age children ages 3 to 5 years, recruited from early childhood education centers (n = 24). <h3>Measurable Outcome/Analysis</h3> Independent variables (IVs) included parent and child demographics, parent weight status, feeding practices, parent role modeling, home meal preparation, and child fruit and vegetable consumption. Binary dependent variables (DVs) included participation in moderate-to-vigorous physical activity (MVPA) and participation in physical activity for more than 60 minutes a day (TPA). Logistic regression models determined associations between IVs and DVs. <h3>Results</h3> The participant's married status (OR = 3.625, CI=3.609-3.641), child weight (OR = 2.920, CI=2.905-2.935), and less spousal meal preparation (OR = 0.450, CI=0.448-0.451) were associated with MVPA. On the other hand, lower parent weight (OR = 0.366, CI=0.364-0.368), less food restriction (OR = 0.509, CI=0.508-0.511), and more food monitoring (OR = 1.618, CI=1.615-1.622) were associated with TPA. <h3>Conclusion</h3> Overall, the results suggest that parent characteristics and feeding practices are associated with child physical activity. Addressing this interconnectedness between eating and physical activity will allow families and providers to better understand how to promote healthy behaviors in children.

Validation of the Adult Eating Behaviour Questionnaire adapted for the French-speaking Canadian population.

The Adult Eating Behaviour Questionnaire (AEBQ) is a newly developed questionnaire adapted from the widely used Child Eating Behaviour Questionnaire. This questionnaire assesses four food approach scales, namely hunger, food responsiveness, emotional overeating (EOE) and enjoyment of food, and four food avoidance scales, namely satiety responsiveness (SR), emotional undereating (EUE), food fussiness and slowness in eating (SE). This study aimed to validate a French version of the AEBQ in controlled conditions among French-speaking adults from Quebec, Canada. The AEBQ was pre-tested through structured interviews with 30 individuals. Participants of the validation study (n = 197, aged 19-65years) had their height and weight measured and completed the AEBQ, Three-Factor Eating Questionnaire (TFEQ) and Intuitive Eating Scale-2 to assess factorial structure, internal consistency and construct validity. Test-retest reliability over 2 weeks was assessed among 144 participants. Confirmatory factor analysis indicated an excellent model fit (NNFI = 0.98, CFI = 0.98, RMSEA = 0.03, χ2/df = 1.17) and provided support for the use of the original 8-factor questionnaire. Internal consistency was adequate for most scales (Cronbach's alpha = 0.66-0.94) and moderate to excellent test-retest reliability was observed for all scales (ICC = 0.70-90). Women showed higher levels of EOE and SR, and individuals with overweight and obesity showed higher levels of EOE and lower levels of EUE and SE. Construct validity was also supported by expected correlations with disinhibition and susceptibility to hunger from the TFEQ and intuitive eating. This study indicates that the French AEBQ is a valid and reliable tool to measure eating behaviours in the adult population of Quebec. Level III: Evidence obtained from well-designed cohort or case-control analytic studies. The data are cross-sectional, but all measurement were undertaken in controlled laboratory conditions and the study provided new information.

Potential Barriers in Implementing Local-Food-Based Complementary Feeding Practice

Local-food-based complementary feeding (LFBCF) practice may be an important approach in the growth and development of children aged 6 to 24 months. This study aimed to describe potential barriers in implementing local food-based complementary feeding practices among mothers in Banyuasin regency, Indonesia. A qualitative study was conducted by using 24 semi-structured interviews and a focus group discussion. Participants were 24 mothers with children aged 6 to 24 months in Banyuasin Regency, Indonesia that recruited purposively. Data were analyzed using thematic analysis. The majority of the mothers were 20-30 years old. All participants have implemented LFBCF practice because local food ingredients are easy to find locally at an affordable price. Community cadres assisted village midwives in integrated health post service such as disseminating information concerning local food recipes and facilitating information exchange among mothers regarding complementary feeding practice. Three main emerged themes identified from this study were: mother's knowledge about local food recipes, mother's knowledge about healthy complementary food preparation, child-eating behavior. Improving the nutritional status of children starts with the family by motivating mothers to provide complementary foods, which also requires the support of local cadres.

Observed behavioral indicators of child satiation at mealtime: Associations with child characteristics and parent-reported child eating behaviors

The notion of promoting parents' recognition of child satiation to reduce overfeeding and overeating in children is prevalent. To do so, it is important to identify common behaviors that may indicate satiation and can be easily recognized by parents. Relatively little work has focused on identifying behaviors that may indicate child satiation as they occur during naturalistic mealtimes, which is an important context for parents to observe their children's eating behavior. Hence, the goal of the current study is to examine whether observed behavioral indicators of child satiation at mealtimes are associated with child characteristics (i.e., sex, age, and BMIz) and parent-reported child appetitive traits. We coded observed behaviors thought to indicate satiation, specifically mealtime disengagement and mealtime negativity, in a cohort of 240 families with children between 4- and 8-years old (53% boys). First, we documented the occurrence of child disengagement and negativity during naturalistic mealtimes. Second, we found that lower child BMIz and being a boy were associated with greater mealtime disengagement, but child age was not associated with mealtime disengagement. No associations were found between child characteristics and mealtime negativity. Third, we found that mealtime disengagement and mealtime negativity were associated with mother-reported satiety responsiveness on the Child Eating Behavior Questionnaire. Taken together, our findings suggest observed mealtime disengagement and mealtime negativity behaviors could be helpful indicators of child satiation in a naturalistic mealtime context.

Disrupted mealtime interactions are associated with stress and internalizing symptoms in caregivers of school-age children

ABSTRACT Caregivers of children with feeding problems (FP) experience more stress and mental health concerns. This study examines the relationship between disruptive mealtime interactions and symptoms of FP with caregiver stress and mental health concerns. A community sample of 198 caregivers of school-age children completed an online survey about child mealtime problems, caregiver perceptions of the severity of their child’s FP, disrupted mealtime interactions severity, caregiver stress, and caregiver depression and anxiety (i.e., internalizing symptoms). Two-thirds of caregivers reported at least 1 mealtime problem. Child picky eating was commonly reported and occurred before and after age 6. Increase in disrupted mealtime interactions and mealtime problem severity was associated with higher ratings of caregiver stress and increased internalizing symptoms. Feeding is an interactive activity between caregivers and children. Caregiver’s perception of FP is important as negative attributions about child feeding behaviors lead to increased risks of caregiver mental health problems. Integrative care providers and psychologists are encouraged to evaluate caregivers’ feeding concerns in addition to traditional objective measures of child nutrition (e.g., growth charts), as the interactions between caregiver stress, internalizing symptoms, and child FP result in poor outcomes.

Associations Between Parenting Stress, Feeding Practices, and Child Eating Behaviors During the COVID-19 Pandemic

ObjectivesThe pandemic provides an opportunity to explore how parenting stress during times of crisis may predict parent-child interactions, especially during mealtimes. The objective of the present study was to explore whether parents’ perceived increases in and overall levels of parenting stress during the pandemic were associated with feeding practices and perceptions of child eating behaviors. MethodsParents (n = 284) of children 4–6 years completed a cross-sectional online survey between March and April 2020. Perceived changes in parenting stress during the onset of the pandemic, levels of parenting stress during the pandemic, child feeding practices, and children’s eating behaviors were assessed. We used ordinal linear regression to examine whether changes in and levels of parenting stress predicted use of controlling or responsive feeding practices and perceptions of child eating behaviors. ResultsThe majority (63.7%, n = 181) of parents indicated their family was moderately or extremely emotionally affected by the pandemic and 56.7% (n = 161) indicated pandemic-related precautions had been moderately or extremely challenging. Perceived increases in parenting stress during the onset of the pandemic were associated with more frequent use of food as a reward (OR = 1.15, 95% CI = 1.04–1.26) and for emotional regulation (OR = 1.13, 95% CI = 1.04–1.23), as well as greater child food responsiveness (OR = 0.91, 95% CI = 0.84–0.99) and slow eating (OR = 0.92, 95% CI = 0.84–1.00). Higher overall levels of parenting stress were associated with more frequent use of food as a reward (OR = 1.05, 95% CI = 1.02–1.08) and for emotional regulation (OR = 1.05, 95% CI = 1.03–1.08) but also with use of pressuring feeding practices (OR = 1.03, 95% CI = 1.01–1.06) and encouraging a balanced diet (OR = 1.03, 95% CI = 1.01–1.06). Higher overall levels of parenting stress were associated with greater child food fussiness (OR = 1.05, 95% CI = 1.02–1.08), enjoyment of food (OR = 1.05, 95% CI = 1.02–1.07), and satiety responsiveness (OR = 0.95, 95% CI = 0.93–0.98). ConclusionsDuring the pandemic, parenting stress predicted parents’ use of food for emotional and behavioral regulation and various domains of children’s eating behaviors. Results highlight the need for targeted efforts to support families during times of crisis. Funding SourcesNone.

Impact of Mothers Participation in a Nutrition Education Intervention on Their Children Eating Behavior

ObjectivesTo determine whether mother’s participation in a nutrition education program influence obese children’s body weight and improving their health behavior. Additionally, this study evaluates changes in attitude toward food, and beliefs for children-mothers dyad participating in the Healthy Habits (HH) program. MethodsFourteen mothers were willing to participate in the intervention. The mother’s intervention was offered to the mothers of children participating in the Healthy Habits group only. Mothers received “what’s app” text messages and materials related to the nutrition education provided for all children in the Healthy Habits group during the 8-week period. ResultsAfter an 8-week intervention, children with maternal support showed significant (21% VS 100%, P.001), (45% VS 95%, P = 0.012) improvement in eating behavior and attitude compared with the other group in the intervention. Maternal eating behaviors, beliefs and attitudes were also significantly (12% VS 95%, P.001), (21% VS 82%, P.001) changed by their participation. ConclusionsMaternal involvement in the Healthy Habits program showed positive effect on children eating behavior in addition to improvement in maternal behavior. Our findings suggest that actively involving mothers in programs to reduce childhood obesity, will magnify the potential effects of the program on children by changing the family dynamics and creating a supportive environment. Funding SourcesN/A.

Exploring Maternal and Children Perspectives Towards Healthy Eating and Active Living in Lebanon: A Qualitative Study

ObjectivesTo explore the perspectives and experiences of children and their mothers towards healthy eating habits and regular physical activity in Lebanon and to identify potential strategies that can be recommended for future interventions to promote healthy lifestyles among children.MethodsQualitative research methodology and the social cognitive theory were used. Focus group discussions and in-depth interviews were conducted with children (aged 10–11 years) and their mothers, respectively, from two private and one public schools in Beirut, Lebanon. Thematic inductive analytical approach was adopted.ResultsA total of six FGDs and 11 in-depth interviews with mothers were conducted from February till November 2020. Four main overarching themes emerged. Theme 1 pertained to the different views of children and mothers regarding the meaning of healthy eating and physical activity and their perceived impact on children's wellbeing. Theme 2 revealed a set of intrapersonal, social, and environmental determinants, which were reported differently between children and their mothers. Participants in our study who were interviewed after the COVID-19 pandemic talked about how their eating habits were adversely affected as a result of the sudden changes in daily schedules, boredom and anxiety. Theme 3 reflected the role of schools and sports facilities in setting a good example for children's healthy eating and active behaviors. Theme 4 revolved around participants’ suggestions to receive support for healthy eating and lifestyle habits at multiple levels, including intrapersonal, family/social, community, and policy-level strategies. Our findings highlight the importance of using theory-driven interventions, such as the social cognitive theory, to improve long-term health behaviors.ConclusionsFindings highlight the multiple influences that pertain to children's eating and activity habits and shed light on the need to use child- and parental-driven strategies in the planning and development of programs to promote children's health and wellbeing.Funding SourcesThis study was partially funded by the Department of Nutrition and Food Sciences at the American University of Beirut.

Associations Between Birthweight and Appetite Traits: Appetite Traits Partially Mediate the Link Between Birthweight and Later Child Weight in Low-Income Hispanic Families

ObjectivesTo examine whether: 1) birthweight was associated with child appetite traits (AT) at age 2 years; and 2) ATs mediated the link between birthweight and weight at age 3 years among Hispanic children. MethodsThis study is a secondary longitudinal analysis of data collected from the “Starting Early Program” randomized controlled obesity prevention trial of low-income, Hispanic mother-child pairs (n = 533). Birthweight-for-gestational-age z-scores (BWGAz) were determined using Fenton growth curves; weight-for-age z-scores (WFAz) were determined using World Health Organization growth charts. Four ATs, including Food Responsiveness (FR), Enjoyment of Food (EF), Satiety Responsiveness (SR), and Slowness in Eating (SE), were assessed using the Child Eating Behavior Questionnaire at age 2 years. Simple linear regression analysis was used to assess direct associations between BWGAz and each AT. Bootstrapping analyses were used to assess whether ATs were significantly associated with BWGAz, and mediated the relationship between BWGAz and later child WFAz. ResultsOf the 401 children with both BWGAz and AT measures, 49% were male with mean birthweight of 3.4 kg. After adjusting for covariates related to child weight, infants with higher BWGAz had lower SR scores at age 2 years (B = –0.11, 95%CI = –0.18 to – 0.04, P < 0.01) and higher WFAz at age 3 years (B = 0.39, 95%CI = 0.26 to 0.53; P < 0.001). Lower SR was also associated with higher WFAz at age 3 years (B = –0.42, 95%CI = –0.62 to –0.22, P < 0.001). A significant indirect effect of BWGAz on WFAz at age 3 years through SR at age 2 years was detected (B = 0.04, 95%CI = 0.01 to 0.08; P < 0.01 [indirect effect]); however, only 10% of the total effect was mediated by this indirect pathway. Therefore, SR partially mediated the positive relationship between BWGAz and child WFAz at age 3 years. BWGAz was not associated with other ATs. ConclusionsHigher BWGAz was associated with lower SR scores at age 2 years and higher WFAz at age 3 years. SR partially mediated the link between BWGAz and child WFAz. Our findings warrant exploring additional pathways through which birthweight effects appetite traits, as well as later child weight. Funding SourcesUSDA AFRI.

Factorial validation analysis of the Baby and Children's Eating Behavior Questionnaires in Samoa

Survey instruments for assessing eating behaviors in infancy and early childhood have yet to be validated among Pacific Islanders, among whom the prevalence of pediatric obesity is steadily increasing. This study aimed to evaluate Baby Eating Behavior Questionnaire (BEBQ) and Children's Eating Behavior Questionnaire (CEBQ) factor structures against data collected from mother-infant dyads in Samoa. The BEBQ was administered across two time points: approximately 2 months (mean = 2.37 [SD = 0.34]; N = 105) and 4 months postpartum (mean = 4.22 [SD = 0.44]; N = 117). The CEBQ was administered at approximately 21 months postpartum (mean = 21.45 [SD = 1.72]; N = 113). Both the original four-factor BEBQ and seven-factor CEBQ models failed to replicate in confirmatory factor analyses. BEBQ data from 2 and 4 months demonstrated acceptable fit to a nine-item, two factor model, generated by elimination of factors with low internal reliability. A series of exploratory factor analyses on CEBQ data from 21 months postpartum ultimately revealed 16-item, three-factor structure. There was little correlation between BEBQ and CEBQ scores, suggesting either that infant feeding behaviors before and after weaning are not strongly associated, or that the BEBQ and CEBQ function better in cross-sectional, rather than longitudinal analyses. Newly derived CEBQ factors raise concerns regarding whether original CEBQ items and factors were sufficiently theoretically distinct. Study results suggest that demographic and cultural differences may impact both BEBQ and CEBQ factor structure. Further qualitative research is necessary to address these issues.

Feeding Problems in Typically Developing Young Children, a Population-Based Study.

Feeding problems have been estimated to occur in approximately 25–45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents’ feelings about their child’s feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement.

Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families

BackgroundChild appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight. ObjectiveTo determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children. DesignA secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial. Participants/settingThree hundred twenty-two low-income, Hispanic mother–child pairs enrolled between 2012 and 2014 in a public hospital in New York City. Main outcome measuresATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years. Statistical analyses performedAT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years. ResultsThere was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = –0.18, 95% CI –0.33 to –0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = –0.29, 95% CI –0.47 to –0.12; P < 0.01; B = –0.36, 95% CI –0.55 to –0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = –0.74, 95% CI –1.18 to –0.2 [Slowness in Eating]; B = –1.19, 95% CI –1.87 to –0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002). ConclusionsInfants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.